Job description
Pharmacy Clinical Pharmacist– Clinical Program Senior AdvisorRole Summary:
This position is responsible for the development of formulary strategies involving both pharmacy and medical products, clinical actions following release of new/existing drug products, evaluating and managing drug utilization review, and pipeline product tracking and forecasting. Affordability solutions encompass activities that include utilization management edits at point of service, preferred drug list strategy, retrospective utilization review, risk management review and condition-specific interventions. The position works closely with matrix partners across the medical organization, PBM partners, Contracting, Pharmacy pricing/finance, Clinical Operations, Coverage Policy Unit, Pharmacy and Medical client facing partners, Pharmacy product, Analytics, Compliance, Legal, and Specialty Pharmacy.
Responsibilities:
Execute formulary management strategies for major specialty and non-specialty drug classes across the pharmacy and medical benefit, including designing and implementing specific actions and workflows to drive affordability and meet quarterly targets
Evaluate opportunities for cross-benefit drug management in an integrated model
Develop and implement utilization management strategies and drug utilization review programs to enhance formulary strategies and improve clinical outcomes in alignment with P&T determination
Evaluate the success of current utilization management program to determine areas of enhancement
Organize and coordinate with a team of matrix partners and subject matter experts to assess opportunities to create non-condition based clinical programs
Track and interpret the impact of future market changes, including drug pipeline, regulatory activity, and new product offerings
Provide clinical subject matter expertise to the release and placement of new medications across pharmacy and medical to client facing partners
Provide support to the condition based program managers to enhance clinical affordability and total health outcomes
Coordinate with stakeholders to respond to RFP inquiries
Coordinate with legal and compliance to ensure formulary strategies are in alignment with state and federal regulatory requirements
Coordinate the execution of these actions with partners in Supply Chain, Medical Management, Contracting, Drug Policy, Specialty Pharmacy, Provider Network, , , and other areas that can impact results
Provide education and training for clinical team (Pharmacy Service Center, Home Deliver, Specialty Pharmacy, Medical Management) to communicate clinical strategy and actions and assure consistent execution of class strategy
Other duties as assigned
Qualifications:
PharmD preferred; advanced degree a plus
Licensed Pharmacist required
Minimum of 3 years Commercial formulary management experience preferably in a Health Plan or PBM setting
Experience developing end to end Pharmacy Clinical Programs
Proven capabilities in strategic planning and clinical program development
Solid understanding of evidence based medicine, interpreting clinical literature, and standards of care
Demonstrated ability to work in a highly matrixed environment
Results driven with proven communication, interpersonal and collaboration skills working in a cross-functional and matrixed environment
For this position, we anticipate offering an annual salary of $105,500 - $175,800, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the “Life at Cigna” tab on our careersite: www.cigna.com/careers
About Cigna
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
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